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Louisiana rates for HCPCS 15773

Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$545.00 / $1,520.00 / $3,685.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,996.78 / $3,721.59 / $7,553.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.00 / $1,429.00 / $4,010.00